Application study of periarticular multimodal drug injection in total knee arthroplasty

Objective To investigate and compare the analgesic effect of a periarticular multimodal drug injection and patient-controlled epidural analgesia (PCEA) in total knee arthroplasty (TKA). Methods Thirty-six patients undergoing unilateral TKA were randomly divided into two groups (A and B). Group A received a periarticular injection of ropivacaine, morphine and epinephrine at operation and Group B did not. All patients received postoperative patient-controlled epidural analgesia (PCEA). Preoperative baseline data, surgery-related conditions, postoperative VAS (visual analog score) , range of motion( ROM), time of opening PCEA, drug dosage in PCEA and side effects were recorded respectively. Results At 6, 12 hour VAS in Group A was lower than Group B ( P ＜ 0. 05 ). The time of opening PCEA in Group A was longer than Group B ( P ＜0. 05 ). The drug dosage in PCEA in Group A was less than Group B ( P ＜0.05 ). There was no difference of surgical conditions, ROM, 24/48 hour VAS and side effects between two groups (P ＞0. 05 ). Conclusion Periarticular drug injection during TKA can relieve pain early after TKA, prolong the time of opening PCEA and reduce the drug dosage in PCEA. Key words: Arthroplasty,replacement, knee; Joint prosthesis; Anesthetics,local; Injections